Good posture is important for everyone. In the general population, many back and neck problems stem from poor posture. In addition to this, poor posture decreases a person's ability to weight shift appropriately to maintain balance. Patients with Parkinson's disease are often already set forward due to poor posture and have minimal ability get to neutral let alone shift weight backward without falling. Therefore it is even more important that these patients be diligent about fighting bad posture. So how do you do that?
First, by stretching tight muscles: Pectoral muscles (the front of the chest) Ilipsoas muscle (front of the hip) Hamstrings (back of the upper leg) Gastrocnemius and Soleus (back of the lower leg)
Second, by strengthening the muscles that tend to get weak: Gluteus maximus- buttocks Erector spinae- on either side of the vertebrae of the back Posterior scapular retractors-between the shoulder blades Cervical extensors- in the neck and keep the head from falling forward.
Thirdly, correct positioning at all times: Get rid of extra pillows, only use one pillow to support the small of the neck when you sleep. Sit back against the chair and pull head back- "chin tucks". Walk tall- always think shoulders back, head up, chest out and lead with your heels.
We know exercise works! Many research articles document improvement in balance, confidence, quality of life and reduced fall rates with persons with Parkinson's disease when they are participating in an exercise program. Studies have looked at community verses home based programs and have found improvement with either. Improvement is usually noted in first 3-4 weeks of exercise, with exercise occurring 3-5 times per week. Exercise needs to be a lifelong habit and the benefit fades if exercise stops.
There are many publications with exercises especially for persons with Parkinson's. Many persons not familiar with exercise or anatomy of muscles may have a hard time simply following written instructions for exercises. Don't be overwhelmed! Please ask your physician for a physical therapy referral so that you can be confident and performing exercises that will benefit you maximally. If you are able to safely leave home you can go to an outpatient clinic. If you are rarely and not routinely leaving home you may receive services in your home.
Michelle Elmo is a Physical Therapist, graduate of Grand Valley State with a Masters in the Science of Physical Therapy. She currently works at Gentiva Home Health in Jackson. This article is a portion of her presentation to the Jackson Parkinson Support Group.